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Variation Exists! Outcomes Exist!

EM Literature of Note

Literally every practicing physician working in a hospital environment knows there is a broad spectrum of skill, approach to acute illness, and level of risk-tolerance. These attributes manifest in different ways, and, in emergency physicians, one is the differing likelihood two clinicians might have to admit same patient to the hospital.

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Medical Malpractice Insights: Radiology over-reads – Who’s responsible?

EMDocs

Chuck Pilcher, MD, FACEP Editor, Medical Malpractice Insights Editor, Med Mal Insights Radiology over-reads – Who’s responsible? Patient not informed of enlarged heart, dies 3 weeks post ED visit Miscommunicated radiology findings are a hot topic. If you have a story to share click here. Baccei SJ et al. Tyler W et al.

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Preperitoneal Packing Vs Angioembolization: Part 3

The Trauma Pro

Various hospital outcomes were tabulated, including hospital charges, mortality, and discharge location. AE and PPP have equivalent outcomes. You can feel comfortable that outcomes will be the same as AE. This eliminated patients who might have received other additional management that could cloud the data.

Fractures 113
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Contrast Media Shortage of 2022 – Lessons Learned

EMDocs

1 The shortage in supply posed difficulties for hospitals that significantly depend on GE Healthcare as their supplier, which encompassed approximately 50% of hospitals in the United States (US). Production levels increased steadily back to baseline, achieving normal supply levels in February 2023. 11 Table 1. 11 Table 1.

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The PROPHY-VAP Trial: Ceftriaxone to Prevent VAP in Patients with Acute Brain Injury

RebelEM

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62 4, 8 Paper: Dahyot-Fizelier, C.,

CDC 111
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SGEM#418: I Ain’t Missing You – Spinal Epidural Abscess

The Skeptics' Guide to EM

Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Implementation of a Clinical Management Tool for Spinal Epidural Abscess Early Diagnosis. AEM October 2023.

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Trauma Resuscitation Updates

RebelEM

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. NEJM 1994. [2]